Ending teenage pregnancies in Malawi with contraceptives

BLANTYRE, Malawi — As Malawi forges ahead with our development plans, we need to address the challenge of rapid population growth. As explained by many experts, unchecked population growth threatens our development as a nation.

In the last 10 years, our population has grown by 30 percent but our economy has not kept up with this growth.  It is, therefore, important to look at ways to better manage a healthy and self-reliant population, particularly as we work to develop our nation and move out of poverty.

As we look to our commitment to achieving Sustainable Development Goals 3 and 5; we must look to promoting better family planning.  This means improving universal and equal access to sexual and reproductive health care services, family planning, information, education and integration of reproductive health into national strategies and programmes.

As a nation, we, Malawians, must acknowledge the importance of contraception in terms of our health, public resources and economic development and the effect such issues have on the country. In this regard, it is important to acknowledge the important role that our partners have played in supporting the government in health delivery services.

One outstanding partner that has worked with the Ministry of Health for over 30 years in providing sexual and reproductive health services across Malawi is Banja la Mtsogolo (BLM). The organisation has supported more than 1.9 million women with modern contraception services. This includes over 300,000 long acting and permanent methods.  This has helped to prevent over one million unintended pregnancies every year.

Let me point out when BLM launched its operations in 1987, each household had an average of 8 children and the national population was around 6 million. At that time, contraceptive use was not widely understood offering a real challenge for both government and our development partners.

Thirty years on, the 2015-16 Malawi Demographic and Health Survey reported that Malawi’s population is at 17 million and each household has an average of 4 children.

The survey further indicated that the number of women of reproductive age using modern contraception has increased significantly from 13 percent in 1992 to 59 percent in 2015-16. This uptake of contraception has been the main contributing factor in the reduction in family sizes. Contraception also reduces the burden of maternal mortality by 38-41 percent and averts over 2,100 maternal deaths annually while also helping to prevent the spread of HIV and Aids as well as other sexually transmitted diseases.

As both access to health services improve and the nature of care improves, many more of our children survive.  Our population has almost doubled over the last 15 years and so couples are now looking to reduce the size of their families.  We know that there are still 19 percent of women that have an unmet need for contraception. Despite this challenge there are positive signs in our attitude towards the use of contraception.

It is now pleasing to note that many women are choosing female sterilization and implants. Such methods are more reliable and offer couples a great degree of protection from unwanted pregnancies. These solutions are offered for free at family planning clinics.

Our biggest challenge remains educating our youth. The 2015-16 Malawi Demographic and Health Survey highlights teenage pregnancies increasing at an alarming rate. Despite all the gains we have seen in the uptake of contraception and reduced family size, more teenage girls are becoming pregnant than ever before. This I can attest to as I visit many maternity wings that are frequented by extremely young mothers. Not only does this contribute to our rapid population growth but also leads to fewer young women able to graduate from school but also increases the risks of unsafe abortion and obstetric fistula.

Our focus now must be reaching out to our young men and women to take more care of themselves.  As parents we must take more responsibility in ensuring our children stay in school and complete their studies. This will not only improve their life prospects, but also significantly contribute to the development of our economy.

It is a pity that many adolescent girls’ hopes for the future have been shattered because they did not know about contraception or where to get it. Yet it is one of the simplest and most affordable ways to transform lives, enabling girls to finish their education, focus on their goals and aspirations and improve opportunities for future generations.

My message to young people in Malawi is that modern contraceptives are for everyone. We must remove the stigma that hinders young people from accessing these services. We must also accept that teenagers will be teenagers. If they are sexually active then as parents, teachers and community leaders we must help them better plan their lives by, among others, addressing unintended pregnancies in style amongst them through the use of contraceptives.

 The author is Malawi’s Minister of Health and Population